Mission Primary Care Clinic Pllc - Medicare Primary Care in Vicksburg, MS

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Mission Primary Care Clinic Pllc is a medicare enrolled primary clinic (Family Medicine) in Vicksburg, Mississippi. The current practice location for Mission Primary Care Clinic Pllc is 1901 Mission 66, Vicksburg, Mississippi. For appointments, you can reach them via phone at (601) 636-0097. The mailing address for Mission Primary Care Clinic Pllc is 1901 Mission 66, Vicksburg, Mississippi and phone number is (601) 636-0097.

Mission Primary Care Clinic Pllc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1487852018. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (601) 636-0097.

Contact Information

Mission Primary Care Clinic Pllc
1901 Mission 66
Vicksburg
MS 39180-3711
(601) 636-0097
(601) 629-9969

Map and Direction


Primary Care Clinic Profile

Full NameMission Primary Care Clinic Pllc
SpecialityFamily Medicine
Location1901 Mission 66, Vicksburg, Mississippi
Authorized Official Name and PositionBill Fulcher (ADM)
Authorized Official Contact6016360097
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mission Primary Care Clinic Pllc
1901 Mission 66
Vicksburg
MS 39180-3711

Ph: (601) 636-0097		Mission Primary Care Clinic Pllc
1901 Mission 66
Vicksburg
MS 39180-3711

Ph: (601) 636-0097

NPI Details:

NPI Number1487852018
Provider Enumeration Date07/05/2007
Last Update Date05/25/2022

Medicare PECOS Information:

Medicare PECOS PAC ID5890764914
Medicare Enrollment IDO20040927000415

Medical Identifiers

Medical identifiers for Mission Primary Care Clinic Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1487852018NPI-NPPES
04935090MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary
363LF0000XNurse Practitioner - Family R829001 (Mississippi)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Mission Primary Care Clinic Pllc acts as a billing entity for following providers:
Provider NameDenesia Yvonne Giffin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568490241
PECOS PAC ID: 6507832318
Enrollment ID: I20040902001248
Provider NameJohn R Barnes
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1205865680
PECOS PAC ID: 1355302696
Enrollment ID: I20041021000722
Provider NameJoseph L Wilson
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1568560530
PECOS PAC ID: 9537183439
Enrollment ID: I20060123000424
Provider NameRobert Lee Giffin
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1376584052
PECOS PAC ID: 3870560626
Enrollment ID: I20110215000188
Provider NameSusan A Chiarito
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1871534008
PECOS PAC ID: 3678540333
Enrollment ID: I20110301000570
Provider NameJohn Robert Ford
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1356363915
PECOS PAC ID: 4486836632
Enrollment ID: I20110309000056

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.